Medicare Medicaid Category

Medicare & Medicaid

News articles in this section include actions by federal regulators like the CMS and HHS, as well as information on Medicare and state Medicaid coverage and benefits.

Medicare Advantage Plans Shift Their Financial Risk to Doctors

Dr. Christopher Rao jumped out of his office chair. He'd just learned an elderly patient at high risk of falling was resisting his advice to go to an inpatient rehabilitation facility following a hip fracture. 

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Verma, Azar Take Aim at ‘Medicare for All’ Proposals

Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma took another swipe at calls for a “Medicare for All” healthcare system this week, saying expanding those benefits to every American would “dilute” the program. 

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Immigrants’ Health Premiums Far Exceed What Plans Pay For Their Care

President Donald Trump has repeatedly condemned U.S. immigration policy, arguing that many immigrants pose a threat to the nation and drain U.S. resources. But a study released Monday about health insurance challenges the president’s portrayal.

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Drugmakers Play The Patent Game To Lock In Prices, Block Competitors

David Herzberg was alarmed when he heard that Richard Sackler, former chairman of opioid giant Purdue Pharma, was listed as an inventor on a new patent for an opioid addiction treatment.

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Feds Settle Huge Whistleblower Suit Over Medicare Advantage Fraud

One of the nation’s largest dialysis providers will pay $270 million to settle a whistleblower’s allegation that it helped Medicare Advantage insurance plans cheat the government for several years.

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Medicaid Spending Hit $581B in 2016. Here’s How Its Projected to Grow Over the Next Decade

Medicaid provided healthcare coverage to 72.2 million people in fiscal year 2016, an increase of 3.1% over 2015.

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Ruling On Health Care Subsidies Could Prove Costly for Government

A federal court ruled this month that a Montana insurer is entitled to federal compensation for subsidy payments under the Affordable Care Act that President Trump abruptly ended last October, a ruling that could reverberate through insurance markets and cost the government hundreds of millions of dollars.

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Paper Jam: California’s Medicaid Program Hits ‘Print’ When The Feds Need Info

In the shadow of Silicon Valley, the hub of the world’s digital revolution, California officials still submit their records to the feds justifying billions in Medicaid spending the old-fashioned way: on paper.

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New Medicare Advantage Tool To Lower Drug Prices Puts Crimp In Patients’ Choices

Starting next year, Medicare Advantage plans will be able to add restrictions on expensive, injectable drugs administered by doctors to treat cancer, rheumatoid arthritis, macular degeneration and other serious diseases.

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California Grapples With Growing Physician Shortage For Low-Income Patients

When Paul Lyons opened a primary-care practice in the Palm Springs area for low-income patients, the need was clear.

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